AIM:To investigate the effect of conjunctival approach and skin approach on postoperative complications in orbital blowout fracture through Meta-analysis.

METHODS: Search literatures in PubMed, Web of Science, Cochrane library, OVID, Chinese biomedical literature database, Weipu, Wanfang and CNKI database from the establishment of the database to May 30, 2018. The main contents included randomized controlled trials and cohort studies about comparing the postoperative complications of orbital blowout fracture through the transconjunctival approach and subciliary approach. Meta-analysis of the incidence of complications was performed using Review Manager 5.3 statistical software.

RESULTS: A total of 7 cohort studies were included. The Newcastle Ottawa Scale(NOS)score showed that the quality of the included literature was above 6 points. Meta-analysis showed no significant difference in odds ratio(OR)between the transconjunctival approach group and subciliary approach group \〖OR=0.74, 95% CI (0.44-1.24), P=0.25\〗. Sensitivity analysis showed that the results of the Meta-analysis were stable and reliable. Funnel plot analysis showed that there might be publication bias in the included literature.

CONCLUSION: The effect of skin approach and conjunctival approach on the incidence of postoperative complications of orbital blowout fractures is not significant. The two approaches have their own advantages and disadvantages. It is necessary to combine the clinical practical considerations to select the most suitable surgical approach.